TCRA术中应用透明质酸钠-羧甲基纤维素防粘连膜与宫内节育器对再粘连的预防效果  

The preventive effect of sodium hyaluronate-carboxymethyl cellulose anti-adhesion film and IUD on readhesion in TCRA

作　　者：吕瑛 俞梦雅 夏琼 LYU Ying;YU Mengya;XIA Qiong(Department of Intrauterine Diseases and Interventional Therapy,Hunan Maternal and Child Health Hospital,Changsha 410000,Hunan,China)

机构地区：[1]湖南省妇幼保健院宫内疾病与介入治疗专科,湖南长沙410000

出　　处：《中国现代医生》2024年第18期58-61,72,共5页China Modern Doctor

摘　　要：目的探究在宫腔粘连电切术(transcervical resection of adhesion,TCRA)中应用透明质酸钠-羧甲基纤维素防粘连膜+宫内节育器(intrauterine device,IUD)对再粘连的预防效果。方法选取2021年2月至2022年2月在湖南省妇幼保健院接受TCRA治疗的中重度宫腔粘连患者89例,采用信封法将患者分为对照组(n=44)和研究组(n=45)。对照组患者放置IUD,研究组患者在对照组的基础上加用透明质酸钠-羧甲基纤维素防粘连膜。比较两组患者术后宫腔粘连情况、疗效、月经恢复情况及美国生育协会(American Fertility Association,AFS)评分,并记录患者随访1年内的妊娠情况。结果与对照组比较,研究组患者再粘连发生率降低(P<0.05);术后月经恢复良好率高于对照组(P<0.05);治疗总有效率高于对照组(P<0.05);患者的AFS评分在粘连范围、粘连类型、月经模式得分及总分方面均低于对照组(P<0.05)。两组患者的妊娠率比较差异无统计学意义(P>0.05)。结论透明质酸钠-羧甲基纤维素防粘连膜与IUD结合使用可降低TCRA术后再粘连发生率,提高术后月经恢复的良好率和治疗总有效率,且不影响患者的临床妊娠率。Objective To explore the preventive effect of sodium hyaluronate-carboxymethyl cellulose anti-adhesion membrane plus intrauterine device(IUD)on readhesion in transcervical resection of adhesion(TCRA).Methods A total of 89 patients with moderate to severe intrauterine adhesions who received TCRA treatment in Hunan Maternal and Child Health Hospital from February 2021 to February 2022 were selected,patients were divided into control group(n=44)and study group(n=45)using the envelope method.Patients in control group were placed with IUD;Patients in study group were treated with sodium hyaluronate carboxymethyl cellulose anti adhesion film in addition to control group.The intrauterine adhesion,curative effect,menstrual recovery and American Fertility Association(AFS)scoring were compared between the two groups,and the pregnancy status of the patients within one year of follow-up was recorded.Results Compared with control group,the incidence of readhesion in study group patients decreased(P<0.05);The good rate of postoperative menstrual recovery was higher than that of control group(P<0.05);The total effective rate of treatment was higher than that of control group(P<0.05);The AFS scoring of study group patients were lower than those of control group in terms of adhesion range,adhesion type,menstrual pattern score,and total score(P<0.05).There was no statistically significant difference in clinical pregnancy rate between the two groups(P>0.05).Conclusion In TCRA,the combination of sodium hyaluronate-carboxymethyl cellulose anti-adhesion membrane and IUD can significantly reduce the incidence of readhesion,improve the postoperative good rate of menstrual recovery and the overall treatment response rate,the clinical pregnancy rate was not affected.

关 键 词：透明质酸钠-羧甲基纤维素防粘连膜 宫内节育器 宫腔粘连电切术 再粘连 

分 类 号：R713[医药卫生—妇产科学]